Provider Demographics
NPI:1477186203
Name:KIM, JIN HEE (APN-CNP)
Entity type:Individual
Prefix:
First Name:JIN HEE
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 STATION BLVD APT 406
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4077
Mailing Address - Country:US
Mailing Address - Phone:224-595-7244
Mailing Address - Fax:
Practice Address - Street 1:3416 S ROUTE 59 STE 108
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8147
Practice Address - Country:US
Practice Address - Phone:630-416-1151
Practice Address - Fax:331-333-1154
Is Sole Proprietor?:No
Enumeration Date:2020-02-20
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277003399363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner